Publications

Published: June 2011

Paracetamol toxicity in children - let's reduce the risk

Prescriber Update 32(2): 11
June 2011

Reports over the last 12 months describing serious adverse reactions in children due to paracetamol toxicity highlight the importance of using this medicine appropriately. Paracetamol liquid remains one of the most commonly used medicines for minor illnesses in children. However toxicity can easily occur if there is confusion over the strength of paracetamol liquid used or the need to calculate or measure the dose.

National Poisons Centre data suggests the number of unintentional chronic overdoses involving paracetamol has increased in children over the last five years. A further breakdown by age indicates this increase is greatest in children aged 0-2 years.

The risk of unintentional overdosing in children can be reduced by:

Healthcare professionals are reminded to inform parents that paracetamol should only be given to children for the treatment of pain and pyrexia, and to ensure the correct dose is given at the correct frequency. Prescribers are also advised to consider limiting the volume of paracetamol liquid prescribed to children to a maximum of 200mL per dispensing. This approach may help to reduce the number of poisonings needing hospitalisation and will reduce the risk of parents using expired medicine.

Key messages

  • The number of unintentional chronic overdoses involving paracetamol has increased in children over the last five years.
  • Parents and caregivers need to be informed about the importance of giving paracetamol for the treatment of pain and pyrexia, at the correct dose, and not to exceed the recommended frequency. Parents should also be reminded to check the dose on the bottle each time before giving.
  • Prescribers should also consider limiting the volume of paracetamol liquid prescribed for children, such as a maximum of 200 mL per dispensing.
  • All paracetamol containing liquids should be fitted with child resistant caps.
  • Accurate measuring devices reduce the risk of unintentional overdosing and should be provided wherever possible. Checking that parents understand how to use these correctly is also important.